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Abstract: A 33-year-old female patient reported frequent occurrence of right lower abdominal pain for the past 3 months, which was sometimes relieved during the period and therefore ignored, but the discomfort worsened in the past 1 week, accompanied by nausea and loss of appetite. The patient was diagnosed with chronic appendicitis by the laboratory test results and the patient’s poor symptom performance. A systematic treatment plan was then developed for the patient, including surgery and medication.
Basic information】Female, 33 years old
Disease Type】Chronic appendicitis
Hospital】The First Affiliated Hospital of Xi’an Jiaotong University
Time of consultation】October 2019
Treatment plan】Surgical treatment (laparoscopic appendectomy) + medication (cefradine capsule, levofloxacin hydrochloride capsule)
【Treatment cycle】In-hospital treatment for 3 days, outpatient review after 1 month
Treatment effect】The condition has been controlled, and the symptoms of right lower abdominal pain, nausea and loss of appetite have disappeared.
I. First interview
When I first saw the patient in the hospital, he said that 3 months ago, he suddenly felt pain in his right lower abdomen, and the discomfort would sometimes decrease, so he thought it was not a big deal and ignored it. After listening to the patient’s description, we made a brief inquiry and learned that the patient had been in relatively good health, did not have other underlying diseases, and had no history of drug allergy. Combined with the results of the examination and the patient’s symptoms, a preliminary diagnosis of chronic appendicitis was made.
II. Treatment history
Because chronic appendicitis recurs after conservative treatment and affects daily life and work, while surgical treatment has a better prognosis and usually does not recur after paying attention to life and diet after surgery, I informed the patient of the necessity of timely surgery after the diagnosis of chronic appendicitis was confirmed, and the patient and his family expressed their understanding and agreed to surgical treatment. After successful general anesthesia with tracheal intubation in the operating room, the patient was placed in a head-down position and the skin of the operating area was routinely disinfected. After the patient was awake, he was sent back to the ward, and the patient’s vital signs were closely monitored.
III. Treatment effect
On the first day after the operation, the patient had no obvious abdominal pain, abdominal distension and other uncomfortable feelings, clear consciousness, good mental state, dry incisional material, no exudation, combined with the patient’s recovery, I advised the patient to take in milk, rice soup and other liquid diet and get out of bed. On the second day after surgery, the patient’s condition was stable, and the right lower abdominal pain, nausea and loss of appetite were reduced. On the third day after surgery, the patient’s condition was controlled, and the symptoms of right lower abdominal pain, nausea and loss of appetite disappeared, and there was no redness, swelling and exudation at the surgical incision, so the patient could be discharged normally.
IV. Precautions
After the operation, I advised the patient to eat a light diet, gradually transition from a liquid diet to a normal diet, control the intake of each meal, and do not recommend the intake of barbecue, hot pot and other irritating food to prevent the condition from getting worse due to improper diet. In addition, if you find that right lower abdominal pain and nausea worsen or persistently do not subside after discharge from the hospital, you should also seek medical consultation. In addition, the prescribed medication should not be discontinued arbitrarily, otherwise it will not achieve good therapeutic effect.
V. Personal insight
When most people find right lower abdominal pain in their life, they mostly think it is due to unclean diet, cold and other factors, and ignore it, which makes the disease treatment delayed, but it is also a precursor symptom of chronic appendicitis, just like the 33-year-old female patient in this case, who initially felt right lower abdominal pain without targeted treatment, which made the disease progress, accompanied by loss of appetite and nausea. Although the patient recovered well after surgical treatment, it had a certain impact on her life before the treatment was done. Therefore, patients are advised to seek medical consultation for any usual discomfort.